title: Enucleation of pancreatic lesions: indications, outcomes, and risk factors for clinical pancreatic fistula.
abstract: BACKGROUND
  There are few large samples and single-center series that focus on the outcomes of pancreatic enucleation and risk factors for clinical pancreatic fistula (PF). This study aimed to evaluate the indications, short- and long-term results, and risk factors for clinical PF after pancreatic enucleation.
  
  
  METHODS
  Patients who underwent pancreatic enucleation from January 2005 to April 2011 at the Peking Union Medical College Hospital in China were included. Clinical data were collected and analyzed.
  
  
  RESULTS
  A total of 119 patients underwent enucleation. PF was the most common complication; the incidence of clinical PF (grades B and C) was 27.7 %. The most common indications were endocrine neoplasms (76.5 %). During a median follow-up of 41 months, no patient developed exocrine insufficiency. Three elderly patients developed non-insulin-dependent diabetes mellitus. One patient with VIPoma developed recurrence and liver metastasis. New York Heart Association (NYHA) class II or III (P = 0.009; hazard ratio (HR) 3.191; 95 % confidence interval (CI) 1.334-7.632), operative time ≥180 min (P = 0.025; HR 2.664; 95 % CI 1.112-6.386) were the independent risk factors for clinical PF.
  
  
  CONCLUSIONS
  Enucleation is a safe and effective treatment for benign and low malignant lesions of the pancreas. NYHA class II or III and operation time of ≥180 min are independent risk factors for clinical PF.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China.
authors.forename: Taiping
authors.initials: T
authors.lastname: Zhang
authors.forename: Jianwei
authors.initials: J
authors.lastname: Xu
authors.forename: Tianxiao
authors.initials: T
authors.lastname: Wang
authors.forename: Quan
authors.initials: Q
authors.lastname: Liao
authors.forename: Menghua
authors.initials: M
authors.lastname: Dai
authors.forename: Yupei
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010182:Pancreatic Diseases / Q000601:surgery*; D010185:Pancreatic Fistula / Q000453:epidemiology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult